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sulfasalazine Side Effects

Also known as: Azulfidine

Analysis of 76,270 adverse event reports submitted to the FDA from 2003 to 2025.

Total Reports

76,270

Death-Related

6,629

8.7% of reports

Hospitalizations

20,613

27.0% of reports

Top Indication

Rheumatoid Arthritis

Most Reported Adverse Reactions

DRUG INEFFECTIVE
29,013
RHEUMATOID ARTHRITIS
19,190
PAIN
15,658
DRUG INTOLERANCE
13,521
ARTHRALGIA
13,161
FATIGUE
13,017
JOINT SWELLING
12,481
OFF LABEL USE
10,749
RASH
10,678
ABDOMINAL DISCOMFORT
9,801
CONTRAINDICATED PRODUCT ADMINISTERED
9,454
CONDITION AGGRAVATED
9,374
ALOPECIA
9,277
ARTHROPATHY
9,001
SYNOVITIS
8,965
TREATMENT FAILURE
8,687
SYSTEMIC LUPUS ERYTHEMATOSUS
8,588
SWELLING
8,508
NAUSEA
8,384
DRUG HYPERSENSITIVITY
8,282

Who Reports Side Effects

Gender Distribution

Female 52,098 (77%)
Male 15,843 (23%)
Unknown 77

Age Distribution

0-17 1,085 (2%)
18-44 12,906 (27%)
45-64 20,646 (44%)
65-74 8,320 (18%)
75+ 4,155 (9%)

Reporting Trend by Year

2003 2025

Reactions in Death Reports

Top reactions reported in 6,629 reports where death was an outcome. These are voluntarily reported and do not establish causation.

Reaction Reports
RHEUMATOID ARTHRITIS 2,082
SYSTEMIC LUPUS ERYTHEMATOSUS 2,074
OFF LABEL USE 2,037
TYPE 2 DIABETES MELLITUS 2,028
JOINT SWELLING 1,999
SYNOVITIS 1,970
RASH 1,961
GLOSSODYNIA 1,958
WOUND 1,945
PSORIATIC ARTHROPATHY 1,939
INFUSION RELATED REACTION 1,933
PAIN 1,910
GENERAL PHYSICAL HEALTH DETERIORATION 1,904
HAND DEFORMITY 1,874
HYPOAESTHESIA 1,874
FATIGUE 1,871
FIBROMYALGIA 1,869
SWELLING 1,847
HEPATIC ENZYME INCREASED 1,840
DUODENAL ULCER PERFORATION 1,834

Reactions in Hospitalization Reports

Top reactions in 20,613 reports where hospitalization was an outcome.

Reaction Reports
DRUG INEFFECTIVE 5,832
RHEUMATOID ARTHRITIS 5,015
PAIN 4,516
ARTHRALGIA 4,487
OFF LABEL USE 4,272
JOINT SWELLING 4,240
FATIGUE 4,179
RASH 3,909
DRUG INTOLERANCE 3,726
CONDITION AGGRAVATED 3,681
SYNOVITIS 3,637
DRUG HYPERSENSITIVITY 3,524
ARTHROPATHY 3,515
NAUSEA 3,311
INFUSION RELATED REACTION 3,271
HYPERSENSITIVITY 3,192
PERIPHERAL SWELLING 3,191
ABDOMINAL DISCOMFORT 3,184
VOMITING 3,105
DIARRHOEA 3,103

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What the FAERS Data Reveals About sulfasalazine Side Effects

The FDA Adverse Event Reporting System (FAERS) contains 76,270 voluntary reports linked to sulfasalazine and its brand equivalents (Azulfidine), spanning 2003 through 2025. Of those, 6,629 (8.7%) listed death as an outcome and 20,613 (27.0%) involved hospitalization. The most common indication reported alongside adverse events was Rheumatoid Arthritis.

Demographic breakdowns help contextualize who is being exposed to the drug. Of reports with known sex, 77% were female and 23% male; age distribution skews toward 45-64, with 20,646 reports in that bracket. The single most reported reaction is drug ineffective with 29,013 submissions, followed by rheumatoid arthritis and pain.

FAERS is a signal-detection tool, not a scorecard. Reports are voluntary, and a single case may list multiple suspect drugs, so numbers above should not be read as incidence rates or per-patient risk. Widely prescribed drugs naturally accumulate more reports than niche therapies even when individual risk is low. These aggregates are useful for spotting patterns that merit further pharmacovigilance, not for choosing between medications. This page is for educational reference only and is not medical advice — speak with a licensed clinician about any side-effect concerns.